State lawmakers have introduced a bill that would limit the number of hours home-care workers could work, in an attempt to address conditions they say are dangerous to the workers' health.

The bill—S6640, A8064—would prohibit 24-hour shifts and cap the workday at 12 hours and the workweek at 50 hours. The bill would apply to home health aides, personal care aides and consumer-directed personal assistants. It also allows workers to voluntarily work more hours.

Current rules have put home-care workers' health at risk and lowered the quality of care they give patients, said Sen. Roxanne Persaud, a Democrat from Canarsie, Brooklyn, who sponsored the bill. Persaud spoke at a rally on Wednesday in Greenwich Village in front of the building where 146 garment workers died in a 1911 fire at the Triangle Shirtwaist factory—a workers' rights landmark.

"We are going to fight hard with all of my colleagues come the new legislative session to ensure that the 24-hour workday for all of you workers is not going to continue," Persaud said. "We cannot afford to allow you to work 24 hours without a break."

New York's highest court in March upheld state Labor Department regulations that advise agencies to pay workers for 13 hours of their 24-hour shifts as long as the aide receives eight hours of sleep time and three hours of meal breaks. The sleep time must include five uninterrupted hours.

The ruling overturned two appellate decisions from 2017 in lower courts that had thrown out the state's regulations.

Sileni Martinez, a home-care worker for 27 years who has worked 24-hour shifts, said she suffered problems with her back and vision and missed out on time with her family.

"I love this work, but it cost me a lot," she said through a translator. "It robbed me of my family, and it robbed me of my health.

There are more than 263,000 people working in private-sector home health care services statewide, according to the Labor Department, including nearly 207,000 in New York City. The home-care industry, which employs many women, immigrants and people of color, is the fastest-growing sector in the state. The median wage for a home health aide is $25,720.

In legislating the issue, state lawmakers must weigh the rights of workers against the affordability of care. Many of the workers are employed by agencies that are supported by Medicaid funding.

For people who need 24-hour care, work would be split into two 12-hour shifts. That would require more money for the two workers—which would increase Medicaid spending, said Al Cardillo, president of the state Home Care Association.

Cardillo said consideration should be given to make sure the bill wouldn't reduce the supply of home-care workers to a point where people would have to receive care at institution rather than at home.

"As a proposal, it needs to be evaluated for the impact on the worker, the client and the health care system," he said.

Funding the plan is complicated by the state's push to hold down Medicaid spending, which is expected to top $79 billion including federal, state and local contributions. The Cuomo administration said last month that it might need to reduce payments to health care providers and insurers to stay within its spending cap.

No funding estimate is included in the bill.

Assemblyman Harvey Epstein, a Democrat representing the East Side of Manhattan who sponsored the bill in that chamber, said the bill should be a legislative priority because it promotes social and economic justice for workers.

"We need to spend money to make this work," he said at the Manhattan rally, "and that's exactly what we're going to do in the next legislative session." —Jonathan LaMantia

H+H launches community-based mental health program

New York City Health + Hospitals' Office of Behavioral Health—in partnership with H+H-sponsored Performing Provider System OneCity Health—this week announced the launch of a program to transition adults with mental health needs from short-term inpatient treatment to an ongoing community-based setting.

OneCity Health is investing more than $4 million in the Pathway Home program as part of Delivery System Reform Incentive Payment funding to implement new models of care to reduce avoidable hospitalizations and lengths of stay, H+H said. The program was created by Manhattan-based nonprofit Coordinated Behavioral Care.

The investment will fund new services—such as aftercare planning, transition needs assessments, help with food and filling prescriptions, and accompaniment to primary care visits—for H+H mental health patients through a contract with Coordinated Behavioral Care and additional partnerships with community-based organizations.

"Instead of patients having to make the connection, we're able to come together to help the patient, take some of the challenges away, and let them concentrate on healing," said Israel Rocha, CEO of OneCity Health and vice president at H+H.

The goal is to monitor patients, show improvement in clinical outcomes and savings, and expand the program throughout the organization, he said.

Four H+H sites—Coney Island, Harlem, Lincoln and Metropolitan—will work with a Pathway Home team to enroll up to 150 patients during a 15-month period. Participating Coordinated Behavioral Care network organizations include Services for the UnderServed, the Jewish Board, Visiting Nurse Services of New York and Samaritan Daytop Village.

The program focuses on "managing an individual in their community in the most comprehensive and holistic way," said Dr. Jorge Petit, president and CEO of Coordinated Behavioral Care. "I think it really speaks to where health care needs to go," he added. —Jennifer Henderson

NY gets big funds to fight opioid crisis

The city and the state will reap a sizable haul of the more than $1.8 billion in federal funding announced on Wednesday to combat the ongoing opioid crisis.

The city Health Department has been awarded nearly $2.4 million as part of some $900 million in funding from the Centers for Disease Control and Prevention to better the understanding of the opioid-overdose epidemic and scale up prevention and response activities, the U.S. Department of Health and Human Services said.

"New York City has finally bent the curve on overdose,” said Health Commissioner Dr. Oxiris Barbot in a statement provided to Crain's. “After seven years of increasing overdose fatalities, 2018 saw a drop through an approach that embraces harm reduction and compassionate care. However, there are still too many New Yorkers dying and to further reduce these needless deaths we need every resource at our disposal. Help from the federal government is critical. We can end this epidemic.”

Funding will go to efforts, such as overdose prevention in hepatitis C programs, anti-stigma training for clinicians, and additional capacity for buprenorphine induction in emergency departments

The state Department of Health has been awarded nearly $6.3 million as part of the funding.

Additionally, following $500 million in funding released earlier this year, the Substance Abuse and Mental Health Services Administration released $932 million in continuation funding to support the second year of the State Opioid Response program.

New York was awarded about $36.8 million to support the second year of the program, for a total take of $92.9 million, according to the Department of Health and Human Services. The program provides flexible funding to state governments for prevention, treatment and recovery services that meet specific needs.

"Our country is seeing the first drop in overdose deaths in more than two decades, more Americans are getting treatment for addiction, and lives are being saved. At the same time, we are still far from declaring victory," said Alex Azar, Health and Human Services secretary, in a statement. "We will continue executing on the department's five-point strategy for combating the opioid crisis and laying the foundation for a health care system where every American can access the mental health care they need." —J.H.

New York-Presbyterian operating profit dips

New York-Presbyterian Hospital reported an operating profit of $126.6 million for the first half of this year, down 9.5% compared to the same period last year.

The hospital attributed the dip in operating profit to an increase in total operating expenses that exceeded an increase in total operating revenue, primarily because of the recent opening of the David H. Koch Center, a 740,000-square-foot ambulatory care facility located on the NYP/Weill Cornell Medical Center campus at York Avenue and 68th Street.

Excess of revenues over expenses clocked in at $420.4 million for the first half of the year, representing a 146.4% increase over the same period in 2018. The bump was thanks to investment performance, the hospital said, which increased by $263.1 million and more than offset the decrease in operating profit.

Net patient service revenue was $3.2 billion for the first six months of this year, up 6.7% compared to the same period last year. The boost was because of upticks in inpatient volume and ambulatory surgery procedures, the hospital said, as well as higher acuity of patients and payment rates. Total operating revenue was $3.3 billion, up 6.8%.

Total operating expenses were $3.2 billion for the first half of the year, up 7.5% compared to the first half of 2018. Specifically, the hospital largely attributed a $106 million, or 6%, increase in salaries, wages and employee benefits to 895 more full-time employees to accommodate investments in nursing, care coordination, information technology, expanded emergency services and the opening of the Koch Center.

Supplies and other expenses also increased $82.4 million, or 8.6%, over the same period, primarily because of an increase in medical and surgical supplies from higher inpatient volume and acuity, a boost in ambulatory surgery procedures and pharmaceuticals for ambulatory oncology visits, and the opening of the Koch Center. —J.H.

AT A GLANCE

MERGER APPROVED: A federal judge gave the green light to CVS' $70 billion deal to buy the health insurer Aetna, saying the deal is "well 'within the reaches' of the public interest," Modern Healthcare reported. The companies had been acting as one since the deal closed in November.

NEUROSCIENCE: A new Mount Sinai research center will focus on better understanding higher cognitive function and applying new knowledge to the diagnosis and treatment of disorders of cognitive function, such as Alzheimer's and Parkinson's diseases, the health system said on Wednesday. The Lipschultz Center for Cognitive Neuroscience was established through a grant from Marc and Jennifer Lipschultz.

RISING TIDE: Operating margins at nonprofit hospitals improved to 2.1% in 2018 compared to 1.7% in the previous year, with smaller hospitals showing the strongest gains, according to the ratings agency Fitch, Modern Healthcare reported.

EMERGENCY MEDICINE: Researchers, including authors from the NYU School of Medicine, observed an increase in hospital visits in the months leading up to an individuals first time entering a homeless shelter, The Wall Street Journal reported. One potential explanation for the findings, which were published in Health Affairs, is that individuals mental health and substance use worsens as their risk of becoming homeless increases.

MEDICAL NEED: New York Attorney General Letitia James is leading a coalition of 19 attorneys general in calling on the U.S. Citizenship and Immigration Services and U.S. Immigration and Customs Enforcement to provide answers regarding the status and oversight of the federal medical deferred action program, which has allowed immigrants to apply to remain in the United States if they are in extreme medical need. The attorneys general wrote in a letter to the acting directors of the agencies that they are "deeply concerned by USCIS's apparent decision to stop considering requests for medical deferred action."

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